Individual provider Active NPI

Ryan Mathis, LICSW

  • Clinical Social Worker
  • Hudson, NH
National Provider Identifier
1033768486
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5055 Issued in NH
Practice address
35 Robin Dr
Hudson, NH 03051-3357
Phone
(603) 557-1589
NPI assigned
Sep 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SWB-2024-1140 NM
Clinical Social Worker 1041C0700X 1120778 MA
Clinical Social Worker 1041C0700X 5055 NH Primary

Addresses

Primary practice location

35 Robin Dr
Hudson, NH 03051-3357

Mailing address

35 Robin Dr
Hudson, NH 03051-3357
Phone (603) 557-1589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH, NM3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20250423000718 MA Practitioner - Clinical Social Worker 3274058177 Reassigns benefits to 1 organization
I20250423001746 NH Practitioner - Clinical Social Worker 3274058177 Reassigns benefits to 1 organization
I20251104003846 NM Practitioner - Clinical Social Worker 3274058177 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1120778MAMDClinical Social Worker
SWB-2024-1140NMMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Mar 18, 2025 Accepting new patients
RJM Solutions LLC Clinical CurrentSince Jun 23, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

170 Commerce Way
Ste 200
Portsmouth, NH 03801
Phone (201) 293-7689

500 Marquette Ave NW
Ste 1200
Albuquerque, NM 87102
Phone (505) 295-6685

Networks

  • CO HMO C-SNP
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • CO HMO D-SNP
  • CO HMO

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1033768486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 ROBIN DR",
            "city": "HUDSON",
            "state": "NH",
            "postal_code": "030513357",
            "telephone_number": "603-557-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 ROBIN DR",
            "city": "HUDSON",
            "state": "NH",
            "postal_code": "030513357",
            "telephone_number": "603-557-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "RYAN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-09",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "SWB-2024-1140",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1120778",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "5055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, NH

Sources for this page

Verify at the official NPI Registry.